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Adult retinopathy of prematurity: retinal complications from cataract surgery
Richard S Kaiser1, Gregory L Fenton, William Tasman
1Retina Service, Wills Eye Institute, Philadelphia, Pennsylvania, USA. KaiserRick@aol.com
Insights
Cataract surgery in adults born prematurely shows mixed visual outcomes and a high risk of retinal complications, often occurring at a younger age. Careful consideration is needed for these patients.
Area of Science:
- Ophthalmology
- Retinal Surgery
- Neonatal Medicine
Background:
- Adults born prematurely may develop cataracts later in life.
- Retinopathy of Prematurity (ROP) is a known complication of premature birth affecting retinal development.
Purpose of the Study:
- To evaluate the outcomes of cataract surgery in adults with a history of premature birth.
- To identify the rate of retinal complications following cataract surgery in this patient group.
Main Methods:
- Retrospective chart review of 66 eyes from 45 patients across two retina services.
- Inclusion criteria: birth weight < 2200 g or gestational age < 32 weeks, age ≥ 15 years at baseline, and cataract surgery with follow-up.
Main Results:
- 56% of eyes showed signs of prior Retinopathy of Prematurity (ROP).
- Visual outcomes were mixed: 38% improved vision, 30% unchanged, 32% declined vision.
- A significant 23% of eyes experienced postoperative retinal tears or detachments.
Conclusions:
- Cataract surgery in individuals with a history of premature birth is often performed at a younger age.
- Visual results are variable, and there is a notable incidence of retinal complications.
- The severity of ROP at baseline did not predict postoperative complications.
Purpose:
To describe the results and retinal complications of cataract surgery in adults with a history of premature birth from two separate retina services.
Design:
Retrospective, noncomparative, interventional, consecutive case series.
Methods:
A retrospective chart review was carried out of two cohorts of patients: Beaumont Hospital and Wills Eye Institute. Eyes of patients were selected who had a birth weight of less than 2200 g or a gestational age of fewer than 32 weeks, were 15 years of age or older at baseline visit, and who underwent cataract surgery in one or both eyes with at least one follow-up examination. A total of 66 eyes from 45 patients were selected and subject to analysis.
Results:
Thirty-seven eyes (56%) had minimal cicatricial changes resulting from Retinopathy of Prematurity (ROP). The mean age of cataract surgery was 40.3 years. Twenty-five eyes (38%) had at least a one-line improvement in vision, 20 eyes (30%) had no change in vision, and 21 eyes (32%) had a decline in vision after cataract surgery. A postoperative complication of a retinal tear or retinal detachment developed in 15 (23%) of 66 eyes. The severity of the baseline fundus changes resulting from ROP did not correlate with the likelihood of developing a postcataract surgery complication. Results were similar between the two cohorts.
Conclusions:
In patients with a history of premature birth, cataract surgery tends to be performed at a young age, has a mixed range of visual results, and can be associated with a high rate of retinal complications.
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